Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Clinical TrialBispectral index monitoring during infant cardiac surgery: relationship of BIS to the stress response and plasma fentanyl levels.
We evaluated the relationship of the bispectral index (BIS) to commonly used indices of depth of anaesthesia in 19 infants enrolled in a prospective study of the stress response to hypothermic cardiopulmonary bypass. ⋯ We were unable to demonstrate a relationship between the BIS and haemodynamic, metabolic or hormonal indices of anaesthetic depth. Further evaluation of the BIS algorithm is required in neonates and infants.
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Paediatric anaesthesia · Nov 2001
Comparative StudyRegional anaesthesia decreases the need for postoperative mechanical ventilation in very low birth weight infants undergoing herniorrhaphy.
We were interested to know whether regional anaesthesia allowed improved respiratory function postoperatively in very low birth weight babies. ⋯ Regional anaesthesia decreases the need for postoperative ventilatory support requirements in very low birth weight infants undergoing herniorrhaphy.
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Paediatric anaesthesia · Nov 2001
Clinical TrialTransoesophageal echocardiographic monitoring during paediatric cardiac surgery: obtainable information and feasibility in 532 children.
We hypothesized that transoesophageal echocardiography (TOE) performed by the anaesthesiologists would be beneficial for monitoring purposes during paediatric cardiac surgery. We present the results for the first 5 years in 532 consecutive children. ⋯ These data stress the safety and ease of performing TOE in children undergoing cardiac surgery. There is evidence for benefit from TOE findings to potentially enhance the therapeutic basis.
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The slipping rib syndrome is an infrequent cause of thoracic and upper abdominal pain and is thought to arise from the inadequacy or rupture of the interchondral fibrous attachments of the anterior ribs. This disruption allows the costal cartilage tips to sublux, impinging on the intercostal nerves. Children with this entity are seldom described in the literature. We present a retrospective review of 12 children and young adults with slipping rib syndrome and a systematic approach for evaluation and treatment.
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Paediatric anaesthesia · Nov 2001
Case ReportsThe anaesthetic management of a deliberately created bronchoatmospheric fistula in bilateral pulmonary hydatids.
Postoperative empyema and bronchopleural fistula are well known complications after surgery for pulmonary hydatid disease. The pneumonostomy technique of deliberately creating a bronchoatmospheric fistula after removal of the parasite has been used to prevent these complications. This technique, however, is an added anaesthetic challenge, especially if the child presents again for surgery before this fistula has healed. We describe the anaesthetic management of such a case where controlled increase of the resistance to the air leak via the fistula during intermittent positive pressure ventilation helped circumvent these problems.